The psychological predictors of acute and chronic pain in women following breast cancer surgery: a systematic review

Monica McCowat, Leanne Fleming, Julie Vibholm, Diane Dixon

Research output: Contribution to journalArticle

Abstract

Objectives: Numerous psychological factors have been found to be associated with acute and chronic pain following breast cancer surgery. However, individual studies tend to be limited to a small number of predictors and many fail to employ prospective designs. This study aimed to identify a broader range of psychological predictors of acute and chronic pain following breast cancer surgery through a systematic review of relevant prospective studies. Methods: Web of Science, psychINFO, PubMed, and MEDLINE databases were searched to identify relevant prospective cohort studies. Studies were included if women were to undergo mastectomy or wide local excision, if psychological factors were assessed before surgery, and pain assessed after surgery. Results: Twelve studies (representing 11 independent cohorts) met the inclusion criteria and described 10 psychological predictors. Anxiety and depression were the most frequently assessed psychological factors, and were measured in nine of the 12 studies. Anxiety and psychological robustness emerged as significant predictors of acute pain. Distress was the strongest predictor of chronic pain. The relationship between depression and chronic post-surgical pain was, at best, mixed. Discussion: This review has identified a range of psychological predictors of acute and chronic pain following breast cancer surgery, however the evidence was conflicting and limited. Future studies should demonstrate adequate power and take account of known confounders.
LanguageEnglish
JournalClinical Journal of Pain
Early online date30 Nov 2018
DOIs
Publication statusE-pub ahead of print - 30 Nov 2018

Fingerprint

Acute Pain
Chronic Pain
Breast Neoplasms
Psychology
Anxiety
Prospective Studies
Depression
Pain
Mastectomy
PubMed
MEDLINE
Cohort Studies
Databases

Keywords

  • acute pain
  • anxiety
  • breast cancer surgery
  • chronic pain
  • depression
  • psychological factors
  • risk factors

Cite this

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title = "The psychological predictors of acute and chronic pain in women following breast cancer surgery: a systematic review",
abstract = "Objectives: Numerous psychological factors have been found to be associated with acute and chronic pain following breast cancer surgery. However, individual studies tend to be limited to a small number of predictors and many fail to employ prospective designs. This study aimed to identify a broader range of psychological predictors of acute and chronic pain following breast cancer surgery through a systematic review of relevant prospective studies. Methods: Web of Science, psychINFO, PubMed, and MEDLINE databases were searched to identify relevant prospective cohort studies. Studies were included if women were to undergo mastectomy or wide local excision, if psychological factors were assessed before surgery, and pain assessed after surgery. Results: Twelve studies (representing 11 independent cohorts) met the inclusion criteria and described 10 psychological predictors. Anxiety and depression were the most frequently assessed psychological factors, and were measured in nine of the 12 studies. Anxiety and psychological robustness emerged as significant predictors of acute pain. Distress was the strongest predictor of chronic pain. The relationship between depression and chronic post-surgical pain was, at best, mixed. Discussion: This review has identified a range of psychological predictors of acute and chronic pain following breast cancer surgery, however the evidence was conflicting and limited. Future studies should demonstrate adequate power and take account of known confounders.",
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AB - Objectives: Numerous psychological factors have been found to be associated with acute and chronic pain following breast cancer surgery. However, individual studies tend to be limited to a small number of predictors and many fail to employ prospective designs. This study aimed to identify a broader range of psychological predictors of acute and chronic pain following breast cancer surgery through a systematic review of relevant prospective studies. Methods: Web of Science, psychINFO, PubMed, and MEDLINE databases were searched to identify relevant prospective cohort studies. Studies were included if women were to undergo mastectomy or wide local excision, if psychological factors were assessed before surgery, and pain assessed after surgery. Results: Twelve studies (representing 11 independent cohorts) met the inclusion criteria and described 10 psychological predictors. Anxiety and depression were the most frequently assessed psychological factors, and were measured in nine of the 12 studies. Anxiety and psychological robustness emerged as significant predictors of acute pain. Distress was the strongest predictor of chronic pain. The relationship between depression and chronic post-surgical pain was, at best, mixed. Discussion: This review has identified a range of psychological predictors of acute and chronic pain following breast cancer surgery, however the evidence was conflicting and limited. Future studies should demonstrate adequate power and take account of known confounders.

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